Perineal tear not healed at ten weeks

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I have a perineal tear that has not yet healed. It was originally stitched but the stitches came out before it healed. At six weeks my doctor did silver nitrate which didn't work and at eight weeks she restitched which didn't work. She then sent me to a wound specialist who said it would have to heal on its own. I am so freaked out and scared that I have an open wound there that isn't healing not to mention my baby who I am exclusively breastfeeding to take care of and a 4 year old. If anyone has any insight about this I would love to hear.

You are now the proud owner of an unstitched perineum. There is a procedure that can be done called perineoplasty, but it's not without it's risks. There is no life or death risks associated with walking around with what you've got going on.
At this point, how long has it been since the 8 week stitch up? (which by the way was never going to work and I'm shocked the doc was willing to do it- basically she just caused you more damage and healing time)
anyway, however long ago it was, I figure you have mostly healed up since it's been at least 8 weeks from the original tear. So I doubt that you are walking around with an open wound (not saying you are not, just saying that would be strange).
If it's not healing by a month out (indicated by what? I don't know...still bleeding from the original tear site maybe?) then you probably want to go back to the doc and figure out why.
anyway, I have some experience with this- my third birth the stitches ripped out and it was a 3rd degree tear- It healed how it healed- Then I tore with the 4th birth- not terrible, but tearing the perineum that's already very short due to a previous tear is not so fun- and then for the 5th birth I was determined not to tear and while I had some "skid marks" kinda like scratches- It held together (at that point it was basically going to tear my anal sphincter if it tore again). So, it can set you up for a rectocele (just my opinion!) a perineoplasty isn't going to change that at this point.
So, my insight is that you are going to be ok, see the doc if it's not granulating and healing up (but remember that depending on how deep it was it heals from the inside out and may take time), and eating good food and rinsing with a herbal rinse is the best bet to encourage healing.

Yes, it is still an open wound. It has been about two weeks since the last stitch up and about a week since seeing the wound specialist who I will see again at the end of the week. I am feeling like it is never going to heal

I am sorry you are in distress,especially as you have 2 little ones to deal with now. That alone can cause a lot of stress. Alemama said a lot of things that make sense to me. She also has personal experience in this area. Wounds take a lot of time to heal. Much more than we usually think. My husband is a regular at the wound center. It usually takes weeks and weeks for proper healing. He also has a compromised immune system. You also have experienced a lot of wear and tear on your body, and are coping with the stress attached to taking care of an infant and a 4 yr. old ( I did have that experience,though years ago). Give yourself a break. Listen to the doctors and try and fit in some quality rest and down time for yourself.
Good luck and keep us posted on the wound healing.
WWPA

It is some relief to hear what the wound specialist said reflected in these comments. My mom is here now helping out and making sure I am eating well. I am trying to accept that this might be a long road to being healed

Hi Amyns,
So sorry ot hear you've had such a distressing time with tearing. However the good news is that so long as the tear is kept clean, it can and will heal. This takes as long as it takes... Things that some women have found helpful include; cold or hot packs, gently patting this area dry after showers, squirting water onto this area after going to the loo and arnica for healing. All aspects of the Whole Woman way will help and I strongly advise you to buy the book if you have not done so already. This is a wonderful resource for health and life.
Love and best wishes, wholewomanukx

Thank you. I am feeling so scared about having an open wound and about not have any sense of how long it will take to heal. Your encouraging words help.

Let's see. When they stitched it last time, did they cut it up first? What happens is that the muscle belly of each side retracts with the tear and subsequent healing and then the only thing they have to stitch together is epithelial tissue- if they debride the perineum there is a better chance for the stitching to *take*. Depending on what they did it will be 6 weeks for primary healing.

In the mean time, you can help the healing along. Here's what I used:
Honey
Seaweed
use the honey like a glue to put on the seaweed patch on the outside of the perineum. You can also roll up the seaweed and insert it vaginally.

rinse made from:
sea salt
tea tree oil
comfrey herb
Echinacea
Calendula
(prepare like you would a tea from fresh herbs- add the salt and tea tree at the end- you can make a big pot of this and store for a few days at a time).

You can also use this like a sitz bath and soak your poor perineum three times a day in it for 20 min each time.

disclaimer: I'm just a mom and this is what worked for me. I'm not an herbalist. You can research these herbs on your own. I like to order mine from mountain rose herbs- I get the organic ones. They ship fast.
I hope you are not straining at all to go poop.

I don't think my ob did debride it before restitching and they started dissolving within days.

I have been doing sitz baths for the last week-- I didn't at all originally and I use the peri bottle every time I go to the bathroom.

I see the wound specialist again Friday and could really use some good news.

I have increased both my protein and fiber intake and drinking lots of water.

My obgyn performed a rectal and after that I had a fissure to deal with. The increase of fiber is healing it up and I am not straining when going to the bathroom.

Yikes, extra fiber to bulk up your poo? Is there no other way to keep things moving? - Surviving

If the stool is hard adding a *bit* of fibre and drinking plenty of water will make it a bit bigger, but softer and more bendy, so it will go round corners easier. Hey, if it means that you are not straining at all, keep doing what you are doing.

Nursing a baby can take a lot of water out of your system, just to make milk. I used to find that I would grab baby first, and my enormous (pint) mug of water second, then go sit down to nurse. In winter I used to keep an urn warm in the kitchen so I always had hot water at night in the cold months when I was getting up to nurse during the night.

Alemama, do you think Amyms should be keeping her legs together?

And do you think WW posture will put a lot of pull on her healing perineum?

Louise

It's really late in the game for it- If you can do it right away and keep doing it until primary closure- that's the way to go. I'm guessing at this point the 'sides' of the open area are individually healing and probably won't heal together.
I don't think there will be a lot of pull, but it's possible it may pull some, but better now than later I think...

Amyns, tell me again why you think it's not healed??? Is the torn area bleeding? raw? or just still separated? What's going on?
and I'm so glad your mom is there to help you.

Alemama,
It is still open. Raw and not healed. I assume it will heal separated at this point. Still burns and stings. The wound specialist said it might take a long time to heal. As much as it hurts, it is the psychological fear of having an open wound there that is even worse. And what the implications are for my future health. I want to get back to being the active person I was but I am stuck tending a wound with no definitive end in sight.

i had a 2nd degree tear n my stitches came out after a week. my wound healed but it didnt heal the two sides together if you know what i mean x

So, this post is kind of old but maybe someone will have some feedback for me. My baby was born May 31; it was a somewhat difficult birth, with the cord wrapped around her neck and then her shoulder stuck. The midwives I had thought I was "borderline" to get stitched and decided not to. Come a week later, they realized I really should have been and I had a pretty deep 2nd degree tear. By then it was too late to stitch. We are almost 5 months later, and I'm still not totally healed. MUCH better, not in much pain anymore, but the top is still open and looks sort of "raw". Just curious if anyone that posted to this thread earlier has a successful recovery story? I'm feeling kind of discouraged at 5 months, wondering when I am going to be totally healed, and can resume my old life again. I think the tear was much deeper than the midwives thought...wish I would have gotten stitched!

Hi kam2481,
I had a 4th degree tear 8wks ago. My stitches came out but i think the wound healed, because i didnt feel any pain at all.
But when i look it up, the skin is still open leaving a gap/hole where i can see the muscle. But again no pain at all.
So i guess im in the same situation as you. The two sides didnt close up.
1/3 of my perineum towards the vagina is closed and intact. The 2/3 of my perineum towards the anus is opened on the sides.
Did you experience any pain at all?
Im so glad I found your post because I cant relate to all others since all of them felt pain.
Did it hurt when you have sex? I havent had any sex because im too scared it will hurt or even tear further.
If you dont mind, please share your experience with me.
Thanks a lot in advance.

Joshmom,
Kam2481's post was made in 2013. We get a lot of people coming and going here, so you may not hear from her, but there has been discussions on perineal tears on here. Just put it in the search box, or maybe one of our other ladies who has had this will pop on.